POS1072 OBESITY AND LOWER LIKELIHOOD OF ACHIEVING MINIMAL DISEASE ACTIVITY AND REMISSION IN PSORIATIC ARTHRITIS PATIENTS
Authors: E. Vallejo-Yagüe, T. Burkard, B. Moeller, A. M. Burden
Journal: Annals of the Rheumatic Diseases (2022)

Background Among patients with psoriatic arthritis (PsA), obesity is a common comorbidity, and it is associated with difficulted disease management. This may be explained by the understanding of obesity as a low-grade inflammatory disease, which shares pathological pathway with PsA. Objectives We aimed to assess the impact of elevated body mass index (BMI) on the achievement of successful clinical outcomes in PsA patients within one-year after starting their first biologic or targeted synthetic disease-modifying anti-rheumatic drug (b/tsDMARD). Methods This observational cohort study was performed using data from the Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) registry (from 1997 to July 31 st 2019), and it included adult PsA patients starting their first b/tsDMARD. Patients were classified according to their BMI as normal weight (BMI &lt;25), overweight (BMI 25.0-29.9), and obese (BMI ≥30). Overweight and obese patients were compared to the normal weight group (reference group). Logistic regression (crude and adjusted by confounders) was used to assess the impact of elevated BMI category on the achievement of clinical outcomes at ≤12-months after start of the patient’s first b/tsDMARD. These clinical outcomes included Minimal Disease Activity (MDA), as well as remission defined by Disease Activity for Psoriatic Arthritis (DAPSA), clinical DAPSA, and 28-joint disease activity score (DAS28). Similarly, the likelihood of treatment persistence at one year was compared between the overweight and obese groups vs the normal weight group. Additionally, the overlapping or accordance across the study outcomes was investigated. Results The study included 306 (39.53%) normal weight, 285 (36.82%) overweight, and 183 (23.64%) obese patients. Compared to the normal weight group, obese patients had lower odds of achieving MDA at ≤12-months (Adjusted odds ratio [ORadj] 0.45, 95% confidence interval [CI] 0.24-0.82). This was consistent with the observed reduced odds of achieving DAPSA remission (ORadj 0.42, 95%CI 0.21-0.85), clinical DAPSA remission (ORadj 0.51, 95%CI 0.27-0.96), and DAS28 remission (ORadj 0.51, 95%CI 0.32-0.81) in obese vs normal weight patients. No differences were observed in treatment persistence across the BMI strata. And there was high overlap between achievement of MDA and clinical DAPSA remission. Conclusion Among PsA patients starting b/tsDMARDs, obesity was associated with ca. 50% reduced odds of achieving MDA and remission in comparison to normal weight patients, while it did not impact treatment persistence. Acknowledgements We thank all patients and rheumatologists contributing to the SCQM registry, as well as the entire SCQM staff. A list of rheumatology offices and hospitals which contribute to the SCQM registry can be found at http://www.scqm.ch/institutions . A list of financial supporters of SCQM can be found at http://www.scqm.ch/sponsors . We would like to add a personal thank you to Axel Finckh (University Hospitals of Geneva) for his input regarding the database. AMB acknowledges that her professorship is partly endowed by the Swiss National Pharmacy Association (PharmaSuisse) and the ETH Foundation. Disclosure of Interests None declared